NPI | 1528012267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NY 022861-1) |
Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: NY 022861-1) |
2251X0800X Physical Therapist, Orthopedic (Licence: NY 022861-1) | |
Enumeration Date | 2006-05-19 |
Last Update Date | 2008-04-08 |